For those of us that have Sleep Apnoea, life is a little different, namely, we use a CPAP machine overnight to help us breathe normally. Obviously, if your condition is due to weight then, of course, that is an issue to work on, but not all Sleep Apnoea is due to being overweight. Once using a CPAP machine, life is no different in the day and there are no restrictions with life, all is good. However, the practicalities and lack of portability of most CPAP machines do raise some interesting challenges for those of us that love the outdoors.
With this blog post, I hope to open up minds and inspire people to go hike and not let these excuses or worries hold you back. Many other sites and forums talk about it and also mention car camping, but I ACTUALLY do it. Using this equipment I have backpacked many amazing places around the world, camped at over 12,000 ft and seen some stunning views I never thought possible. I certainly don't let it hold me back, so don't let it hold you back!
Disclaimer: I am not a doctor and am not offering any medical advice. This blog post is just the knowledge I have picked up along the way enabling me to pursue my ambitions.
Over the years I have been asked many questions about how I hike/backpack when I use a CPAP machine. If you think that using a CPAP machine will restrict your outdoor life, then think again. Yes, you will need to spend some money and carry a bit of extra weight, but most things are still possible. With so many questions and lack of information about hiking with a CPAP machine I thought I would build up this blog post to help and inspire those with Sleep Apnoea to get out and about and show you that it doesn't mean you can't hike. I have walked several trails around the world at low and high elevations whilst still receiving therapy from a CPAP machine.
So first let's discuss some typical scenarios:
Backpacking (Travel) - commonly called hotel or hostel hopping this is a great way to see the world. Typically although you are concerned with the weight, it isn't your main priority. You normally have access to electricity so portability isn't a serious issue either. In this case, just something sensible that fits in a backpack/case which runs on 100-240V is normally fine.
Car Camping - Again unit size/weight isn't an issue as you are not carrying anything, so any machine will typically work as long as you have a way of either running on a battery in a remote campsite or you can hook up to an electricity point at a more established campsite.
Backpacking (Wilderness) - This is the tricky one where weight, size and battery efficiency are everything. Unfortunately as with all things wild camping, ultralight costs money.
Over the years the equipment has advanced tremendously, I started as a car camper taking my huge Remstar machine and a 3 phase cable to hook up to campsite electricity, then swapped the power supply to a car battery, most CPAPs had DC adapters to use a DC plug/socket even years back. Then a new system came onto the market called Transcend, made by Somnetics. It has made it so much easier to enjoy what I love.
CPAP Equipment I use when backpacking
I guess I use 2 different setups depending upon if I use lightness, this is mainly to keep the more expensive Transcend batteries for the trips/adventures when weight really matters, e.g. multi-day trips.
For Car Camping / Overnighters
Philips Respironics Wisp Mask, weight 140g, cost £119
4ft Lightweight Travel Tubing, weight 60g, cost £24.99
Transcend Auto machine, weight (without case etc) 450g, cost £499
Transcend DC Mobile Power Adaptor, weight 170g, cost £90
Tracer Lithium 8Ah battery (96Wh), weight 600g (lasts approx 13h), cost £140
Tracer Lithium 22Ah battery (264Wh), weight 1250g (lasts approx 13h), cost £290
For Multi-day Hikes
Philips Respironics Wisp Mask weight 140g, cost £109
4ft Lightweight Travel Tubing weight 60g, cost £30
Transcend Auto machine, weight (without case etc) 450g, cost £499
Transcend P8 Multinight battery (97Ah), weight 500g (lasts approx 14h), multiple batteries may be required. Cost £299 each
Optional: Transcend Solar Charger weight 275g, cost £250
CPAP Batteries
Lithium batteries have come on a long way over the past few years but they are still the defining factor of how long you can stay out, especially in non-sunny climates. Get to know your batteries and their expected life. I tend to be very restrictive and regimented with battery life and rationing. This is mainly to reduce the number of batteries and hence the weight I am carrying. When planning a multi-day trip work out the number of hours you need, typically I ration for 7 hours a night. If I need more sleep then I rely on solar to get me those extra hours of battery life.
I know that Transcend multi-night battery lasts 14 hours at low elevation, so this is good for 2 nights. If I am at elevation then I use the solar to just charge the battery and get another hour or so to cater for the battery loss. Worst case scenario if there is no sun I reduce the sleep to 6 hours per night. If I am going just for 1 night or an odd number of nights then I do not have to be so strict with sleep hours as I have a little extra left. I try and still make a battery last 2 nights just to reduce the number of change overs I need in the night. charging the battery on solar even just for an hour or two helps creep the battery out to stop prematurely running out.
Some other batteries available
Ridgemonkey Power Vault C, 288Wh, cost £199 (weighs 1.45kg)
CPAP Solar Chargers
This picture shows the Transcend solar charger in use in Yosemite snow. 7 hours in the sun added about 4 hours of battery life and gave me some much needed extra sleep.
I do not recommend relying on solar chargers. There may be no sun, such as the Appalachian Trail, it just depends on the conditions. However, I do normally take one on multi-day trips because it allows me to add a few hours extra to a battery. This is especially useful on colder winter darker evenings when you may be stuck in your tent or bag for up to 12 hours. A few hours charging in the sun may give you an extra couple of hours battery life allowing an early night or a lay-in.
Get to know your charger, charge your batteries at home and get a feel for the type of sun and how long you get extra on the battery. It is surprising but you can estimate approximately with experience.
Travel Restrictions
Remember most airlines allow an unlimited number of lithium-ion batteries up to 100Wh, but get more restrictive above that, typically they also allow 2 batteries 101 - 160Wh. Also, you will need to carry all your lithium-ion batteries in your carry on luggage. Just remember the larger batteries over 160 are impossible to get on a plane so are only really of use when car camping.
General Hints & Tips
Here are some general hints, tips and observations I have found over the years.
Batteries are prone to cold and you can lose a part of a volt. This will affect the length of time they last for. Most lithium batteries will recover when warm, so even if they are in a cold pack all day, if you warm them up before using, it won't affect their use.
At altitude, the batteries will not last as long. The air is thinner and the machine will be working harder at altitude. I typically find around the 10-15k ft when the machine is set to no max I lose 20% battery time so take account of this when doing multi-day hikes.
In the cold, sleep with your batteries for maximum life. The machines are generally OK. Although the operating temperature of the Transcend is officially 5C to 35C, I have used it at -7C no problem.
In cold weather, you will get condensation in your mask and will need to wipe it out with a tissue a couple of times a night. I have not found a way around this as it is just due to the temperature difference, just like condensation on the inside of your tent. I am finding you can avoid this if you use the mask as a snorkel in your bag or quilt.
Make sure you ration out your battery life at the start of the trip. Do not be tempted to use 12 hours of battery on the first night just because it is cold and wet and you want to sleep. Stick to your rationed hours in the beginning. If you get some sun then of course use the solar charger to top up your battery so you can have some extra hours asleep.
Reduce the maximum pressure your CPAP will deliver. Often it only hits this level when you have a mask leak. Mask leaks and runaway pressure can be battery killers. My average is now 8 (after some weight loss), so I set the max to 10 when hiking to stop any unnecessary loss.
The Future
Well, nothing stands still with electronics, already there is the Z1 available at just 300g, but the batteries weigh the same as the Transcend, seem to cost the same and there is no solar charger or DC charger. There was a product called Airing being developed but in 5 years it hasn't happened and is unlikely to I suspect.
If you have any questions on hiking with a CPAP machine, please feel free to get in touch.
Update January 2020: The Transcend has a new shape now but is fundamentally the same. Currently, there are no new developments that I am aware of. I still use the same equipment above.